Optimizing glycemic control and cardiometabolic risk remains a key focus in the management of type 2 diabetes mellitus (T2DM). A retrospective cohort study published in Diabetes Therapy evaluated changes in clinical parameters following initiation of once-weekly subcutaneous semaglutide in Chinese clinical practice.

The SCHOLAR study used data from the Tianjin regional electronic health records database and included 26,859 adults with T2DM in the full analysis set. The primary endpoint was the change in glycated hemoglobin (HbA1c) and the proportion achieving HbA1c < 7.0% at month 6, with corresponding outcomes at month 12 as secondary endpoints. Exploratory assessments included lipid parameters, medication use, and safety outcomes.

Among individuals with available HbA1c measurements, 3055 were included in the 6-month analysis (baseline HbA1c 7.65%), and 2897 in the 12-month analysis (baseline HbA1c 7.75%). Mean HbA1c decreased by 0.65%-points (95% CI −0.71 to −0.59) at 6 months and by 0.47%-points (95% CI −0.53 to −0.41) at 12 months (both p < 0.0001). The proportion of individuals with HbA1c < 7.0% increased from 40.4% at baseline to 57.9% at 6 months and 49.8% at 12 months. In those with baseline HbA1c ≥ 7.0% (mean 8.59%), HbA1c decreased by 1.17%-points at 6 months (95% CI −1.25 to −1.08; p < 0.0001).

Total cholesterol, low-density lipoprotein cholesterol, and triglycerides decreased at 12 months (p < 0.05). Among individuals continuing therapy, the mean daily insulin dose and the number of combined oral antidiabetic, antihypertensive, and lipid-lowering medication classes decreased at 6 and 12 months (all p < 0.05). In the full analysis set, constipation (1.73%), diarrhea (0.91%), and abdominal discomfort (0.89%) were the most frequently reported adverse events. Overall, initiation of once-weekly semaglutide was associated with changes in glycemic and lipid parameters, with reported adverse events consistent with its established safety profile in this population.